> Health Maintenance Organization (HMO) Managed-care insurers — known generally as HMOs — use a primary care physician as a gatekeeper to screen patients and see that appropriate treatment takes place at the lowest level possible. In order to see a specialist or receive specialized care, patients must see the gatekeeper physician first and be referred on.
> Exclusive Provider Organization (EPO) EPOs allow subscribers to visit any physician within the contracted network without prior approval or referrals. Services received outside the network may not be covered.
The landmark COBRA health benefit provisions became law in 1986. The law amends the Employee Retirement Income Security Act, the Internal Revenue Code and the Public Health Service Act to provide continuation of employer-sponsored group health coverage that otherwise might be terminated. The Centers for Medicare & Medicaid Services (CMS) has advisory jurisdiction for the COBRA law as it applies to state and local government (public sector) employers and their group health plans.
The COBRA law generally applies to group health plans maintained by employers with 20 or more employees in the prior year. The law does not, however, apply to plans sponsored by the governments of the District of Columbia or any territory or possession of the United States, certain church-related organizations or the federal government.
Individuals who work for a state or local government employer, and their dependents, should be aware of their rights regarding COBRA. A good starting point is reading your summary plan description (SPD) booklet, if a state or local government employer distributes an SPD to its employees. Most of the specific rules on COBRA rights may be found there or with the person who manages your health benefits plan.
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There are several areas of risk that you should consider if you operate a business in your home.
These include: Business-related personal property coverage (computers, furniture, etc.) Inventory Off-premises coverage for business-related personal property Business property of others accounts receivable (up to a specified limit) Liability coverage may include personal injury, products and completed operations, incidental contractual liability, and general commercial liability. Electronic data processing coverage Valuable papers Business interruption and extra expense
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Mar 02, 2007 - Group Insurance Coverage Most Americans get health insurance through their jobs or are covered because a family member has insurance at work. This Read more >
Mar 02, 2007 - Growth In U.S. Health Care Spending Slows Despite the slowdown, the share of household personal income spent on health care rose from 5.4 percent in 2001 to 6 perce Read more >
Mar 02, 2007 - More Americans Struggle With Health Care Costs TUESDAY, Dec. 12/2006 (HealthDay) More Americans are forced to spend more of their family income on health care, and more Read more >
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